Objectives

Giant gastric and duodenal ulcers (>2-3 cm in greatest dimension) are reported to have higher rates of complication and mortality and to be associated with increasing age, renal failure, and use of nonsteroidal antiinflammatory drugs (NSAIDs).

This study investigated the outcome and associations of gastric and duodenal ulcers>2.5 cm compared to ulcers of lesser size.

Methods

Records from all patients with gastric and duodenal ulcers>0.5 cm diagnosed by upper endoscopy between January 1994 and September 1995 were studied for evidence of concurrent use of aspirin, NSAIDs, methamphetamine, and cocaine, as well as for transfusion requirements, length of hospital stay, mortality, surgery, rebleeding, Helicobacter pylori infection, and malignancy.

Results

A logistic regression analysis of the 220 patients identified revealed that recent methamphetamine and/or cocaine use was significantly predictive of giant ulcer formation (p=0.0002) with an odds ratio of 9.66.

Also significant was younger age (p=0.026) and aspirin or NSAID use (p=0.046).